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Research > PEDS exam 1 > Flashcards

PEDS exam 1 Flashcards

1
Q

Why shouldn’t an infant drink water?

A
  • Can cause fullness so baby doesn’t drink milk and will be nutrient deficient
  • can cause electrolyte imbalances (leading to potential seizure)
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2
Q

what is the correct way to measure length in an infant?

A
  • infant should should lay supine, fully extend body holding head in midline, grasping knees together gently and pushing down on the knees
  • top of head to heels of feet (feet with toes pointing towards ceiling)
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3
Q

How to weigh an infant?

A

• Use an infant scale
• Balance the scale before each weight (with clean sheet of paper)
• Infant should be weighed NUDE (diaper off) and in a lying position
-We need to measure exactly to the OUNCE

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4
Q

What is typically included in an infant well child visit?

A 
o	Height, weight, head circumference and plotting
o	Vital signs
o	Developmental screening
o	Nutritional assessment
o	Physical examination
o	Anticipatory guidance
o	Immunizations
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5
Q

How to obtain head circumference for an infant?

A
  • Measure the head at its greatest circumference (usually slightly above the eyebrows and pinna of the ears and around the occipital prominence at the back of the skull)
  • Repeat measurement for accuracy
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6
Q

Until what age do we measure head circumference?

A

from birth to 3 years

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7
Q

Why do we measure head circumference in infants and toddlers?

A

To make sure the skull and brain are growing adequately

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8
Q

All growth in brain occurs during what time frame?

A

birth to 3 years

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9
Q

Between birth to 6 months, what is the AVG weight gain?

A

5-7 oz/week

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10
Q

At what age should an infant’s birth weight be doubled?

A

by 5-6 months

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11
Q

Best way to take an infants temp?

A

axillary (rectal is more accurate but not necessary!)

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12
Q

Between birth to 6 months, what is the AVG head circumference growth?

A

1.5cm increase per month

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13
Q

Between 6 months to 1 yr, what is the AVG weight gain?

A

3-5 oz/week

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14
Q

At what age should an infant’s birth weight be tripled?

A

by 1 year

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15
Q

Between 6 months to 1 yr, what is the AVG height growth?

A

1/2 inch/month

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16
Q

Between birth to 6 months, what is the AVG height growth?

A

1 inch/month

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17
Q

Correct way to measure an infants temp?

A

o Place tip under arm in center of axilla and keep close to skin (not clothing); hold infant’s arm firmly against side

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18
Q

Normal axillary temp in an infant

A

99-99.7f

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19
Q

How to take heart rate in an infant?

A
  • Apically
  • Heard through the stethoscope held to the chest at the apex of the heart (4th intercostal space midclavicular); count the pulse for 1 full minute because of irregularities
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20
Q

Normal heart rate in an infant

A

80-150 (up to 200 with excitement/fever)

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21
Q

normal respiratory rate in an infant

A

24-50

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22
Q

How to measure RR in an infant?

A

o Observe ABDOMINAL movements; count for 1 full minute due to irregular respirations

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23
Q

what is the most widely used developmental screening tool?

A

The Denver II test

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24
Q

What is the Denver II test?

A

4 areas of focus are: Gross Motor, Language, Fine Motor and Personal-Social. (from birth to 6 yrs)
• The examiner should be trained by a master instructor
• In general: Mostly used to screen for developmental delays
• Child is expected to perform every item to the left of the line and items that intersect the line that are in the 75-90th % (shaded box)
• The best source of info about child is the PARENT(S)

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25
Q

what happens to BP, HR, and RR as kids get older?

A

BP: increases
RR: decreases
HR: decreases

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26
Q

developmental milestones for a 1 month old?

A

• 1 month: can turn head from side to side, grasp reflex is strong, follows to midline, makes comfort sounds during feeding

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27
Q

developmental milestones for a 2 month old?

A

• 2 months: when prone can lift head to 45 degrees, hands often open, when supine follows to beyond midline, gurgles, holds placed rattle, smiles spontaneously

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28
Q

developmental milestones for a 4 month old?

A

• 4 months: raises head and chest with arm support, sits head steady, inspects and plays with hand, reaches and grasps rattle, makes consonant sounds “b” , watches hand, calms when spoken to/picked up/sucking/or looking, self-soothes to sleep

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29
Q

developmental milestones for a 6 month old?

A

• 6 months: primitive refelxes GONE! no head lag, pulls to sit and sits tripod, holds bottle, reaches and shakes rattle, passes cube, looks for yarn, will turn head to side when hears voice, imitates sounds, babbles, LAUGHS, shows interest in other infants, **foot to mouth when supine

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30
Q

developmental milestones for a 9 month old?

A

• 9 months: postural reflexes present, ROLLS BOTH WAYS, sits well- no support, raking pincer grasp (touches cheerio w/ finger), bangs two cubes together, understands no, may say “Mama”, “Dada”, waves bye bye

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31
Q

developmental milestones for a 12 month old?

A

• 12 months: crawls, pulls to stand, stands alone, walks with help, can sit down from standing position, puts block in a cup, pincer grasp, can turn pages in a book, holds bottle, says 1 word other than mama and dada understands simple commands, waves bye bye, uses “cause and effect toys”

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32
Q

AAP recommends that women breastfeed exclusively for how long?

A

first 6 months at least

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33
Q

AAP

A

american academy of pediatrics

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34
Q

recommended breast milk or formula for a NEWBORN TO 3 MONTH OLD

A

1-6 oz every 2-4 hours (varies with age and weight)

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35
Q

recommended breast milk or formula for a 4 TO 6 MONTH OLD

A

6-8 oz every 4-6 hours

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36
Q

recommended breast milk or formula for a 7 TO 11 MONTH OLD

A

6-8 oz every 6-8 hours (with a maximum of 32 oz per day

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37
Q

infants should stay away from cow’s milk until what age?

A

at least 1 year

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38
Q

Rules about mixing water with baby formula

A
  • Can be mixed with tap water (or bottled water)
  • Use only COLD H20 from tap & run tap for 2 minutes before using (minimizes lead)
  • Must refrigerate formula once mixed (decreases bacteria)
  • Formula that baby does not drink (left in the bottle) must be discarded (bacteria)
  • To minimize waste, parents should prepare only as much as infant will consume
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39
Q

Why is it recommended to mix fruit with iron-fortified baby cereal?

A

vitamin C helps the iron absorb

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40
Q

when does a baby start to produce tears?

A

after 3 months

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41
Q

when does the posterior fontanel close?

A

by 2 months

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42
Q

when does the anterior fontanel close?

A

by 12-18 months

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43
Q

Approx how many teeth should an infant have by 1 year?

A

4-8 teeth

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44
Q

It’s normal for an infant to appear bowed until…?

A

until lower back and leg muscles are well-developed (usually until they are actively crawling and walking)

-Further evaluation is needed if it persists beyond ages 2 to 3 years, especially in African American children.

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45
Q

How can we check for dislocated hips in an infant?

A

look for uneven gluteal folds or do Ortolani’s test and listen for click/clunk (infants feel no pain during this test)

46
Q

foreskin in infant boys is not retractable until what age?

A

until 1-2 years of age

47
Q

babies are obligate nose breathers until what age?

A

~5 months

48
Q

Between birth to 3 months of age, how much should a baby sleep?

A

10-16 hr/day

49
Q

Between 3 to 6 months, how much should a baby sleep?

A

14 hrs/day

50
Q

Between 6 to 12 months, how much should a baby sleep?

A

12-14 hours/day

51
Q

name two methods to help with teething pain

A

cool objects and tyelenol

52
Q

3 indications of an infant’s mental health

A
  1. good growth & development
  2. child & parents interactions (eye contact, secure holding & cuddling, comforting)
  3. Infant’s ability to self-comfort
53
Q

How often is tummy time recommended for infants?

A

Parents should do it after every time they change a diaper for 5-10 minutes

54
Q

What is the recommended at home mngt post immunizations?

A

o Mild pain/fever: analgesic (acetaminophen)
o Local redness and swelling: ice/benadryl
o Fever for more than 3 days; or high fevers (105 or >), or high-pitched cry, or seizures: are RARE side effects and need immediate medical mngt (these are very rare, they happen in 1 out of 3 million children but are still possible)

55
Q

how long is required by law that a child should be in a rear-facing car seat? How long does AAP recommend?

A

law: until 1 year
AAP: until 2 years

56
Q

At what age do you start to measure a child’s BMI?

A

2 years

57
Q

Normal heart rate range for toddler

A

70-110

58
Q

Normal respiration rate for toddler

A

20-30

59
Q

Normal temp for toddler

A

99F

60
Q

Normal BP for toddler

A

90-105SBP/55-70DBP

61
Q

Normal growth for a toddler

A

3 inches per year (4-6 lbs/year)

62
Q

What is the leading cause of death in 1 to 4 year olds

A

unintentional injury

63
Q

_______ is the leading cause of injury death in toddlers

A

motor vehicle injury

64
Q

What are some causes of developmental delays in children?

A
  • Genetic syndromes
  • Prematurity
  • Perinatal infections/toxin exposures (fetal alcohol syndrome)/hypoxia
  • Hypoxia during delivery
  • Vision impairments
  • Hearing impairments
  • Lead exposure
65
Q

On average, an 18-month-old can speak how many words?

A

15 words

66
Q

On average, a 24-month-old can speak how many words?

A

50 words or more

67
Q

Developmental milestones for 4 years old

A

hops, speech all understandable with complete sentences, follows 3-step commands, copy cross, draw person 2-4 parts, brush teeth no help, dress no help, can count 4 objects, walks down stairs alternating feet, walks backward, indicates need to void, complex sentences/jokes/teasing, creates imaginary roles, preferred friend, offers sympathy to peers

68
Q

Developmental milestones for 3 years old

A

pedals tricycle, broad jump, 3 to 4 word sentences, follows 2-step commands, speech 75% understandable, build tower of 10 cubes, thumb wiggle, imitates horizontal line, put on T shirt, uses spoon and fork well and drinks from open cup,

69
Q

Developmental milestones for 2 years old

A

walks up and downstairs WITHOUT help, can kick a ball forward, builds tower 6 cubes, feeds doll, names 1 picture, says about **50 words or more, uses 2 word phrases, uses pronouns “I”, “me”, PARALLEL PLAY, brush teeth with help, helps dress , uses SPOON to self feed, speech is 50% intelligible

70
Q

Developmental milestones for 18 months

A

WALKS ALONE, walks up and down stairs holding on, runs, builds tower of 2-3 cubes, says **15 or more words, scribbles, self feeds (fingers), follows one step commands, points to 6 body parts

71
Q

Why can too much milk be bad for toddlers?

A

Can cause them to be iron deficient (too much calcium doesn’t allow the iron to be absorbed)

72
Q

At what age can kids start to drink cow’s milk?

A

1 year

73
Q

At what age can kids start to drink water

A

6 months

74
Q

Do toddlers need more or less calories than infants?

A

Less!

75
Q

How much milk per day is recommended for toddlers?

A

No more than 2 cups

76
Q

How many calories do preschoolers need in a day?

A

Preschoolers need 90 cal/kg: average 1800 cal/day

77
Q

Primary dentition should be completed by what age

A

30 months

78
Q

how much sleep per day is healthy for a toddler?

A

8-13 hours

79
Q

toddler age

A

1-3 years

80
Q

preschooler age

A

3-6 years

81
Q

Avg age for potty training?

A

Boys: 2.5-3yrs
Girls: 2-2.5yrs

82
Q

lead paint was banned in what year

A

1978

83
Q

at what age can we start teaching kids about dialing 911?

A

preschool age (starting at age 3)

84
Q

1 gm of wet diaper equals ___ ml of urine

A

1 ml

85
Q

avg urine output for children

A

1-2mg/kg/hr

86
Q

what is the antidote for acetaminophen?

A

mucomyst

87
Q

pediatric dose of acetaminophen

A

10-15mg/kg/dose (q4-6hrs)

88
Q

at what age can kids stat to be able to swallow pills and capsules?

A

5 years old

89
Q

proper eye medication administration for toddler

A

gently press lower lid down and have the child look up as the drop is instilled into the lower conjunctival sac.

90
Q

Proper ear medication administration for toddler

A

pull pinna down and back (3yo)

91
Q

proper nasal drop administration for toddler

A

hyperextend the head and place the tip of the dropper just at the nasal opening

92
Q

proper nasal spray administration for toddler

A

upright position, place tip of spray bottle just inside the nasal opening and squeeze container

93
Q

Avg heart rate for school age child

A

60-110

94
Q

avg respiration rate for school age child

A

20-25

95
Q

avg temp for a school age child

A

98-98.5

96
Q

avg BP for school age child

A

SBP 95 – 110 / DBP60 – 75

97
Q

Avg growth for school age child

A

2.5 inches/year and 7 lbs/year

98
Q

Developmental milestones for 5 year old

A

• 5 years old: catches ball, skips, balance on one foot 10 seconds, names 4 colors, recalls parts of a story, counts 10 blocks, copy square, draws 10-part person, play board games, speech 100% intelligible, washes and dries hands thoroughly

99
Q

Physical assessment for school age child

A
  • ***Explain what’s going to be done before it’s done
  • Respect need for privacy
  • Talk to child during exam and explain findings
  • Use words child will understand
  • Proceed from head – to – toe
  • Permanent teeth begin to come in
  • Assess for scoliosis
  • Begin to see secondary sex characteristics (Also need to look at Tanner stages)
100
Q

amt of sleep needed for school age child

A

8-12 hrs (depending on child and activity level)

101
Q

most children loose their first tooth at what age?

A

6 years old

102
Q

how is “overweight” categorized in a child?

A

85-95 BMI percentile

103
Q

how is “obese” categorized in a child?

A

95 or higher BMI percentile

104
Q

how is “healthy weight” categorized in a child?

A

5-85% BMI

105
Q

Overweight children are at higher risk for developing:

A 
o	Diabetes Mellitus Type 2
o	Hypertension
o	Asthma
o	Obstructive sleep apnea
o	Non-alcoholic liver disease
o	Early puberty or menstruation
o	Anorexia/bulimia
o	Depression
o	Low self esteem
o	anxiety
106
Q

the most predictive indicator of childhood obesity is:

A

parental obesity

107
Q

To sit in a regular car seat with lap belt and shoulder seat belt, you must be how tall?

A

at least 4’9”

108
Q

kids over ____lbs should use a belt positioning forward facing booster seat located in back seat

A

40lbs (4-8 years old)

109
Q

for kids, height is taking laying down until typically what age?

A

2 years

110
Q

What is the earliest age at which a satisfactory radial pulse can be taken in children?

A

2 years

-Satisfactory radial pulses can be taken in children older than 2 years. In infants and young children, the apical pulse is more reliable.

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